- Certain additives found in ultra-processed foods are linked to increased type 2 diabetes risk, a new study finds.
- The mixtures are typically present in broths, dairy desserts, fats, sauces, and sugary drinks.
- Experts break down the findings.
Ultra-processed foods, or packaged foods that contain food additives (substances that enhance food’s texture, shelf-life, taste, and appearance) represent up to 60% of Americans’ daily diet. Now, research suggests that particular combinations of additives may increase type 2 diabetes risk.
Meet the experts: Kara Siedman, R.D.N., a registered dietitian and certified diabetes care and education specialist with Resbiotic; and Rekha Kumar, M.D., an endocrinologist, chief medical officer at Found, and member of Prevention’s medical review board
The study, published in PLOS Medicine, delves into a link between diabetes risk and gut health. “We know from existing research that disruptions to the gut microbiome can significantly affect blood sugar balance and other metabolic imbalances,” says Kara Siedman, R.D.N., a registered dietitian and certified diabetes care and education specialist with Resbiotic. This study adds another layer by suggesting how specific additives, and particular combinations of them, may contribute to type 2 diabetes development.
Ahead, experts explain the potential link between food additives and blood sugars.
What did the study find, exactly?
Researchers collected data from 108,643 French adults via questionnaires and periodic 24-hour dietary records over roughly 16 years. At the study’s end, a total of 1,131 type 2 diabetes cases were detected.
With food logs and using particular brand names of the ultra-processed foods participants ate, researchers identified five main additive mixtures within participants’ diets and found a higher diabetes incidence in two of them: Mixture 2 and Mixture 5.
Mixture 2 contained starches, pectin, guar gum, carrageenan, polyphosphates, potassium sorbates, curcumin, and xanthan gum, which are emulsifiers, preservatives, and a dye commonly found in broth, dairy desserts, and fats and sauces. Mixture 5 contained citric acid, sodium citrates, phosphoric acid, sulphite ammonia caramel, acesulfame-K, aspartame, sucralose, arabic gum, malic acid, carnauba wax, paprika extract, anthocyanins, guar gum, and pectin, which are acid regulators, dyes, and artificial sweeteners found in sweet drinks and sodas. In general, these additives are often in foods marketed as “sugar-free” or “low-calorie,” says Rekha Kumar, M.D., an endocrinologist, chief medical officer at Found, and member of Prevention’s medical review board.
How might these additives impact blood sugar?
The research suggests that the two highlighted additive mixtures spike diabetes risk by potentially upsetting the gut microbiome, or the balance of good bacteria in your gut, which may cause inflammation, lead to insulin resistance—two aspects that affect blood sugar, Dr. Kumar explains. Such a disruption of the gut is medically known as dysbiosis, she adds, which may increase intestinal permeability, allowing bacterial endotoxins to enter the bloodstream to trigger inflammation—“a commonly recognized factor in the development of insulin resistance,” Dr. Kumar adds. The study also noted that the additives may trigger sweet cravings and an increase in appetite, which in turn may lead to weight gain, a factor of insulin resistance and type 2 diabetes.
Ultimately, the results “challenge our previous nutrition thinking that sugars are the key culprit in driving metabolic outcomes,” says Siedman, and encourage us to look more closely at overall diet quality and ingredients. They also acknowledge that “in the real world,” as Siedman puts it, “we are not often exposed to just one additive at a time.” Ultra-processed foods generally contain a variety of them.
The bottom line
“In practice, we consistently see individuals with metabolic challenges, issues that we now know can be exacerbated by chronic exposure to ultra-processed foods,” says Siedman. “These findings reinforce a lot of what we’ve observed in clinical settings, that supporting the microbiome is foundational to supporting and optimizing metabolic health.”
Ultimately, more research is needed on the subject. Researchers noted that outcome misclassifications and data mis-tracking can’t be entirely ruled out. Also, causality (meaning that the study did not say that additives cause type 2 diabetes) can’t be founded on a single observational study like this one. Also, ethnicity and religion were also not recorded, plus there was a higher proportion of women pulled from a generally health-conscious population, so the findings can’t be directly extrapolated to broader populations with different demographics and lifestyles.
Dr. Kumar adds that this study underscores her consistent advice to prioritize a diet of whole, minimally processed foods to support better blood sugar control, gut health, and metabolism. “An easy way to do this is to shop the perimeter of a grocery store, focusing on raw fruits and vegetables, proteins, and milk products,” she says. “Try to limit your intake of items in the inner aisles like brightly colored cereals, diet sodas, and pre-processed foods.” Of course, that is sometimes easier said than done. “Highly processed foods are often less expensive and sometimes all a family can afford or find in a food desert,” she adds.
Dr. Kumar concludes: “While food additives are generally recognized as safe in regulated amounts, the study highlights potential chronic health effects that warrant further investigation. It emphasizes the need for a holistic approach to dietary recommendations, which considers both nutrient content and the presence of additives.”
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